Individual provider Active NPI

Carina L Lundtvedt, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1174196687
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25543 Issued in MN
Practice address
2810 Nicollet Ave
Minneapolis, MN 55408-4708
Phone
(612) 873-6963
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25543 MN Primary

Addresses

Primary practice location

2810 Nicollet Ave
Minneapolis, MN 55408-4708

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617000693 MN Practitioner - Clinical Social Worker 4183167380 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc CurrentSince May 20, 2024 Accepting new patients
Hennepin Healthcare System Inc CurrentSince May 20, 2024 Accepting new patients

Locations

2810 Nicollet Ave
Minneapolis, MN 55408
Phone (612) 545-9000

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1174196687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084708",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDTVEDT",
        "first_name": "CARINA",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.